NPIMap

Individual provider Active NPI

Elyse Marie Hewitt, D.O.

  • Internal Medicine Physician
  • Waterford, MI
National Provider Identifier
1083006407
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
5101021911 Issued in MI
Practice address
4400 Highland Rd
Waterford, MI 48328-1222
Phone
(248) 618-6000
NPI assigned
Feb 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 5101021911 MI Primary

Addresses

Primary practice location

4400 Highland Rd
Waterford, MI 48328-1222

Mailing address

24 Frank Lloyd Wright Dr Lbby J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Other practice location 1

1 William Carls Dr
Commerce Twp, MI 48382-2201
Phone (248) 937-5085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181105001398 MI Practitioner - Internal Medicine 1850693565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Therapy Centers, IncGroup PAC ID 5092605717, 140 clinicians
Iha Ooma Primary LLCGroup PAC ID 7012316664, 45 clinicians

Practice addresses (Care Compare)

33010 Northwestern Hwy
West Bloomfield, MI 48322-3634

4400 Highland Rd
Waterford, MI 48328-1222
Phone (248) 618-6000

Hospital & facility affiliations

  • Trinity Health at Home- Southeast Michigan Home health agency, Livonia, MI, CCN 237069
  • Custom Home Health Home health agency, Troy, MI, CCN 237707
  • Tone Home Health Services Home health agency, Farmington Hills, MI, CCN 237634
  • Residential Home Health and Hospice Home health agency, Lapeer, MI, CCN 237495
  • Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
  • McLaren Oakland Hospital, Pontiac, MI, CCN 230207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Ooma Primary LLC Internal Medicine Current Accepting new patients
Iha Ooma Primary LLC Internal Medicine CurrentSince Nov 8, 2021 Accepting new patients
Iha Ooma Primary LLC Internal Medicine CurrentSince Nov 8, 2021 Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

1375 S Lapeer Rd
Ste 210
Lake Orion, MI 48360
Phone (248) 693-5700

4400 Highland Rd
Waterford, MI 48328
Phone (248) 618-6000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1424563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1083006407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR LBBY J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 HIGHLAND RD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483281222",
            "telephone_number": "248-618-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 William Carls Dr",
            "address_purpose": "LOCATION",
            "city": "Commerce Twp",
            "state": "MI",
            "postal_code": "483822201",
            "country_code": "US",
            "telephone_number": "248-937-5085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEWITT",
        "first_name": "ELYSE",
        "middle_name": "MARIE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-22",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101021911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.